Hip Outcome Score-Sports Specific Subscale Research Articles

Inferior Clinical Outcomes Following Endoscopic Proximal Hamstring Repair in Patients with Chronic Degenerative Tears Despite the use of Dermal Allograft Augmentation

PurposeTo compare clinical outcomes in patients undergoing endoscopic proximal hamstring repair with and without dermal allograft augmentation. MethodsA retrospective review of prospectively collected data was performed on patients undergoing endoscopic proximal hamstring repair (PHR) and proximal hamstring repair with dermal allograft augmentation (PHR-A) by a single surgeon between 2016 and 2023. Augmentation was utilized for cases of chronic degenerative tears (> 6 weeks from the time of initial injury) where hamstring tissue quality was deemed poor intraoperatively. A survey of patient-reported outcome measures (PROMs) was completed at a minimum of 1 year postoperatively. PROMs included a Visual Analogue Scale (VAS) for pain; University of California, Los Angeles (UCLA) Activity Scale; modified Harris Hip Score (mHHS); Hip Outcome Score-Sports-Specific Subscale (HOS-SSS); and a Single Assessment Numeric Evaluation (SANE). The proportion of patients achieving the minimal clinically important difference (MCID), patient acceptable symptom state (PASS), and substantial clinical benefit (SCB) for PROMs were compared between groups. ResultsSixty-four patients were included (42 PHR, 22 PHR-A). No differences were seen between the PHR and PHR-A groups in terms of age at surgery (49 ± 12 vs. 54 ± 9, p=0.08), sex, or body-mass index (BMI). There was a significantly longer time to follow-up (41.5±23.4 vs. 20.1±10.2 months, p<0.001) in the PHR group. There were significantly greater postoperative mHHS (82.7±15.1 vs. 72.0±18.0, p=0.02) and SANE (89.6±9.9 vs. 73.6±22.5, p=0.002) scores in the PHR group. There were no significant differences in postoperative VAS, UCLA, or HOS-SSS between groups. A greater proportion of patients in the PHR group achieved a SCB for mHHS (71% vs. 36%, p=0.008). ConclusionsOur study demonstrates inferior clinical outcomes in patients undergoing endoscopic proximal hamstring repair with dermal allograft augmentation compared to patients undergoing endoscopic proximal hamstring repair without augmentation. Level of EvidenceIII, retrospective comparative case series

A retrospective cohort study: dual cannula combined with modified shoelace continuous capsular closure technique versus nonrepair in hip arthroscopic surgery of femoroacetabular impingement

BackgroundOver the years, with the improvement of diagnostic and therapeutic capabilities for hip joint diseases and the advancements in surgical technology, hip arthroscopy has been extensively used. At present, there is ongoing controversy among scholars about whether it is necessary to close the joint capsule after hip arthroscopy. In addition, the clinical effect of repairing the hip joint capsule after hip arthroscopy remains uncertain.PurposeTo evaluate the effect of our modified shoelace suture technique on postoperative hip function and to investigate whether complete closure of the hip capsule is reliable and safe.Study DesignRetrospective study; Levels of evidence: III.MethodsA retrospective review was conducted on patients undergoing hip arthroscopy by a solitary high-volume hip arthroscopic surgeon. The patients were categorized into two groups. The first group consisted of patients who underwent the modified shoelace continuous capsular closure technique. The other group consisted of those who did not receive capsular closure after hip arthroscopy. Patient-reported outcomes including modified Harris Hip Score (mHHS), Hip Outcome Score of Activities of Daily Living (HOS-ADL), Hip Outcome Score Sport-Specific Subscale (HOS-SSS), and visual analogue scale (VAS) were obtained at a minimum of 12 months. Any complications during follow-up were identified and recorded.ResultsA total of 100 patients were followed up for 12–15 months, with an average of (12.3 ± 5.3) months in the study. There were 50 patients in the shoelace capsular closure group (CC group) and 50 patients in the non-capsular closure group (NC group). The surgical time in the suture group was significantly longer than that in the non-suture group. However, there was no statistically significant disparity in the length of hospital stay between the two groups. The mHHS, HOS-SSS, HOS-ADL, and VAS of the CC and NC group were significantly improved compared to preoperative scores at 6 and 12 postoperative months (P < 0.001). Compared with the NC group, the CC group showed a significant improvement in the mHHS, HOS-SSS, HOS-ADL, and VAS at 6 postoperative months (t = 4.885, P<0.001; t = 5.984, P<0.001; t = 4.279, P<0.001; t = 3.875, P<0.001). The mHHS, HOS-SSS, HOS-ADL, and VAS at 12 postoperative months were significantly better in the CC group than in the NC group (t = 5.165, P<0.001; t = 3.697, P<0.001; t = 4.840, P<0.001; t = 3.579, P = 0.001). There were no serious complications during the perioperative period.ConclusionThe modified shoelace continuous capsular closure technique is a reliable and secure method that can be used as an alternative to the conventional capsular closure. It is recommended to perform routine intraoperative repair of the articular capsule at the end of hip arthroscopy, as this has a positive influences on the functional results at short-term follow-up.

Relationship Between Neighborhood-Level Socioeconomic Status and Functional Outcomes After Hip Arthroscopy

Background: Despite the growing volume of neighborhood-level health disparity research, there remains a paucity of prospective studies investigating the relationship between Area Deprivation Index (ADI) and functional outcomes for patients undergoing hip arthroscopy. Purpose: To investigate the relationship between neighborhood-level socioeconomic status and functional outcomes after hip arthroscopy. Study Design: Cohort study; Level of evidence, 3. Methods: A retrospective analysis of prospectively collected data was performed on patients aged ≥18 years with minimum 1-year follow-up who underwent hip arthroscopy for the treatment of symptomatic labral tears. The study population was divided into ADILow and ADIHigh cohorts according to ADI score: a validated measurement of neighborhood-level socioeconomic status standardized to yield a score between 1 and 100. Patient-reported outcome measures (PROMs) included the modified Harris Hip Score, Nonarthritic Hip Score, Hip Outcome Score–Activities of Daily Living, Hip Outcome Score–Sports-Specific Subscale, 33-item International Hip Outcome Tool, visual analog scale for pain, and patient satisfaction. Results: A total of 228 patients met inclusion criteria and were included in the final analysis. After patients were stratified by ADI score (mean ± SD), the ADILow cohort (n = 113; 5.8 ± 3.0; range, 1-12) and ADIHigh cohort (n = 115; 28.0 ± 14.5; range, 13-97) had no differences in baseline patient demographics. The ADIHigh cohort had significantly worse preoperative baseline scores for all 5 PROMs; however, these differences were not present by 1-year follow-up. Furthermore, the 2 cohorts achieved similar rates of the minimal clinically important difference for all 5 PROMs and the Patient Acceptable Symptom State for 4 PROMs. When controlling for patient demographics, patients with higher ADI scores had greater odds of achieving the minimal clinically important difference for all PROMs except the 33-item International Hip Outcome Tool. Conclusion: Although hip arthroscopy patients experiencing a greater neighborhood-level socioeconomic disadvantage exhibited significantly lower preoperative baseline PROM scores, this disparity resolved at 1-year follow-up. In fact, when adjusting for patient characteristics including ADI score, more disadvantaged patients achieved greater odds of achieving the minimal clinically important difference. The present study is merely a first step toward understanding health inequities among patients seeking orthopaedic care. Further development of clinical guidelines and health policy research is necessary to advance care for patients from disadvantaged communities.

Comparable Pain Levels and Functional Outcomes With and Without the Use of Dermal Allograft Augmentation in Endoscopic Gluteus Medius Repair

PurposeTo retrospectively compare the clinical outcomes of patients undergoing endoscopic gluteal tendon repair with and without the use of dermal allograft augmentation. MethodsA retrospective review of prospectively collected data, single-surgeon cohort study was performed on all patients undergoing endoscopic gluteus medius repair (GMR) and gluteus medius repair with augmentation (GMR-A) between April 2017 and April 2022. Dermal allograft augmentation was utilized in cases where intraoperative gluteus tissue quality was poor. An electronic survey of patient-reported outcome measures (PROMs) was completed at a minimum of 1 year postoperatively. PROMs included a Visual Analogue Scale (VAS) for pain; University of California, Los Angeles (UCLA) Activity Scale; modified Harris Hip Score (mHHS); Hip Outcome Score-Sport-Specific Subscale (HOS-SSS); and a Single Assessment Numeric Evaluation (SANE). The proportion of patients achieving the minimal clinically important difference (MCID), patient acceptable symptom state (PASS), and substantial clinical benefit (SCB) for each PROM were compared between groups. ResultsSixty-four patients were reached for follow-up (26 GMR, 38 GMR-A). No differences were found between the groups in terms of demographics. There was a significantly longer time to follow-up in the GMR group (39.4±26.9 vs 24.2±11.7 months, p=0.003). There were no differences between the GMR and GMR-A groups in terms of postoperative PROMs including VAS (3.3±2.6 vs 3.3±2.8, p=0.99), UCLA (5.8±2.1 vs 5.1±2.0, p=0.17), mHHS (70.1±18.1 vs 68.9±17.8, p=0.80), HOS-SSS (67.7±28.9 vs 62.5±30.2, p=0.50), and SANE (71.7±27.9 vs 71.3±22.8, p=0.95). A significantly greater proportion of patients in the GMR group achieved a PASS for UCLA (64% vs. 34%, p=0.02). One patient each in the GMR (3.8%) and GMR-A (2.6%) groups underwent revision gluteus medius repair with dermal allograft augmentation at the final follow-up. ConclusionsOur study demonstrates comparable clinical outcomes with and without the use of dermal allograft augmentation in endoscopic gluteus medius repairs. Level of EvidenceIII, retrospective comparative series

Comparison of Knotless Versus Knot-Tying Suture Anchors for Arthroscopic Repair of Hip Labral Tears.

Both knotless and knot-tying anchors are commonly employed in the arthroscopic repair of hip labral tears. To compare the midterm clinical results of arthroscopic hip labral repair using knot-tying versus knotless suture anchors. Cohort study; Level of evidence, 3. Patients who underwent arthroscopic hip labral repair between January 2017 and January 2021 and who had at least 2 years of follow-up were included. The patients were divided into 2 groups based on the suture anchor type: a 2.9-mm knotless suture anchor (knotless group) or a 1.8-mm knot-tying suture anchor (knot-tying group). All patients underwent femoroplasty for cam lesions and acetabular rim trimming for pincer lesions. The modified Harris Hip Score (mHHS), Hip Outcome Score-Sport-Specific Subscale (HOS-SSS), Hip Outcome Score-Activities of Daily Living (HOS-ADL), 12-item International Hip Outcome Tool (iHOT-12), and visual analog scale (VAS) for pain were administered both preoperatively and postoperatively. The consistency of the outcome scores was assessed using the minimal clinically important difference and Patient Acceptable Symptom State. The statistical significance between groups was evaluated using the Mann-Whitney test and quantile-based analysis of variance. A total of 413 patients were included: 256 patients in the knotless group (median age, 35 years [interquartile range, 31-38 years]; median follow-up, 34 months) and 157 patients in the knot-tying group (median age, 34 years [interquartile range, 30-38 years]; median follow-up, 25 months). There were no significant differences in postoperative mHHS, HOS-ADL, or iHOT-12 scores between the 2 groups. However, there were significant differences, favoring the knotless group over the knot-tying group, in postoperative HOS-SSS (87 ± 2 vs 86 ± 1, respectively) and VAS pain (1 vs 2, respectively) scores (P < .0001 for both). Postoperative synovitis was found in significantly more patients in the knot-tying group than in the knotless group (17 vs 5, respectively; P = .01). In this study, patients who underwent arthroscopic hip labral repair with knotless suture anchors had slightly better postoperative HOS-SSS and VAS pain scores and a lower incidence of postoperative synovitis compared with patients who underwent repair with knot-tying suture anchors.

Poster 222: Long-term Survivorship in Patients with Coxa Profunda and Acetabular Overcoverage: An Average 11-Year Follow-up After Hip Arthroscopy

Objectives: A prior study investigating 2-year patient-reported outcomes (PROs) following hip arthroscopy found that patients with coxa profunda and acetabular overcoverage report worse improvements yet similar overall outcomes scores. Regarding conversion to total hip arthroplasty (THA), however, patients with coxa profunda and overcoverage experienced significantly lower rates of survivorship (88.9% vs 100%; p = 0.04). When considering long-term outcomes, a recent study by Domb et al. found an 85.7% 10-year survivorship in patients after hip arthroscopy. Currently, there remains a paucity of literature on the effects of a deep acetabular socket and pincer-type femoroacetabular impingement on patient outcomes beyond 2-years follow-up. The objective of the present study was to report the long-term survivorship, revision surgery rate, patient satisfaction, pain level, and functional outcome scores in patients with coxa profunda and acetabular overcoverage following hip arthroscopy. Methods: This was an institutional review board-approved retrospective cohort study of patients with coxa profunda and a LCE angle &gt; 40° who underwent hip arthroscopy for labral tears or FAI between November 2002 and May 2013. After failing conservative management, all patients were treated by a single surgeon and received the same capsulotomy technique and postoperative protocol. Patients with a minimum 8-years follow-up, complete PROs, the presence of coxa profunda as indicated by the acetabular wall projecting medial to the ilioischial line, and a LCE angle &gt; 40° were included (Figure 1). Patients with severe osteoarthritis (Tönnis osteoarthritis grade &gt; 2) or any previous hip surgeries were excluded. Patients meeting inclusion and exclusion criteria represented the overcoverage cohort (OC) and were matched 1:1 by sex, age within 8 years, body mass index (BMI) within 5 kg/m2, Tönnis grade, and labral treatment (repair vs debridement) to a matched control (MC) cohort that had a LCE angle between 25° and 40°. Collected postoperative outcomes include conversion to THA, revision hip arthroscopy, patient satisfaction, pain level (0-100), number of corticosteroid injections, and 6 PROs (modified Harris Hip Score (mHHS), Nonarthritic Hip Score (NAHS), Lower Extremity Functional Scale (LEFS), Hip Outcome Score (HOS)–Activities of Daily Living (HOS-ADL), HOS–Sports Specific subscale (HOS-SSS), and 33-item International Hip Outcome Tool (iHOT-33). Pearson χ2 test and Fisher exact test were used to compare categorical variables; two-sample t-tests were used to compare continuous variables. The threshold for statistical significance was set to 0.05. A survival analysis was performed using Kaplan-Meier curves. All statistical analyses were performed using Stata software (version 18.0; StataCorp). Results: A total of 38 patients in the OC cohort were 1:1 matched with 38 patients in the MC cohort. There were no differences in patient demographics including age, BMI, sex, Tönnis grade, labral treatment, follow-up duration, and Beck classification of labral damage or transition zone (chondrolabral junction) cartilage damage (Table 1). At an average of 11.3 years postoperatively (minimum 8-years follow-up), patients in the OC and MC cohort experienced similar rates of conversion to THA (OC: 11 [28.9%] vs MC: 6 [15.8%]; p = .169) and revision hip arthroscopy (OC: 4 [10.5%] vs MC: 1 [2.6%]; p = .165). The average time from primary hip arthroscopy to conversion to THA was 8.0 ± 6.5 years for OC and 3.7 ± 3.0 years for MC (p = .144) with the OC cohort converting to THA between 6.5 months to 17.14 years while the MC cohort ranged from 4.8 months to 7.8 years. Age at conversion to THA was 54.3 ± 8.0 years for the OC cohort and 59.0 ± 4.0 years for the MC cohort (p = .195). By Kaplan-Meier survival analysis, patients showed similar rates of survivorship (84.2%) at 12 years after hip arthroscopy; however, OC patients showed a 13.1% decrease in long-term survivorship (71.1%) between years 12 and 18 (Figure 2). Additionally, OC and MC patients showed similar levels of patient satisfaction, pain level, postoperative corticosteroid injections, and scores for all 6 PROs (Table 2). Conclusions: Patients with coxa profunda and overcoverage (LCE angle &gt; 40°) showed similar levels of survivorship, revision arthroscopy, patient satisfaction, pain level, number of corticosteroid injections, and PROs to a 1:1 matched cohort of patients with normal acetabular coverage (LCE angle between 25° and 40°) at a minimum 8-years after primary hip arthroscopy. When analyzing long-term survivorship after 12 years, however, patients with overcoverage showed a 13.1% decrease in long-term survivorship (71.1%) compared to a matched control cohort. Overall, a greater focus on extended follow-up care after hip arthroscopy is needed to improve long-term survivorship in patients with a deep acetabular socket and pincer-type femoroacetabular impingement.

Long-term Survivorship and Outcomes of Patients Without Dysplasia Undergoing Capsular Repair During Primary Hip Arthroscopy for Femoroacetabular Impingement Syndrome

Background: There is a paucity of literature evaluating long-term outcomes and survivorship of patients undergoing primary hip arthroscopy with capsular repair for femoroacetabular impingement syndrome (FAIS). Purpose: To report 10-year survivorship and patient-reported outcomes (PROs) after primary hip arthroscopy with capsular repair for FAIS and evaluate the effect of capsular repair in patients at the highest risk for conversion to arthroplasty. Study Design: Cohort study; Level of evidence, 3. Methods: Data were prospectively collected and retrospectively reviewed on all patients undergoing primary hip arthroscopy with capsular repair between October 2008 and February 2011. Patients with a minimum 10-year follow-up on the modified Harris Hip Score (mHHS), Nonarthritic Hip Score (NAHS), and visual analog scale for pain (VAS) scores were selected. The preoperative and minimum 10-year follow-up Hip Outcome Score—Sports Specific Subscale (HOS-SSS) scores were also reported, if available. Patients with ipsilateral hip surgery, worker’s compensation, Tönnis osteoarthritis grade >1, and hip dysplasia (lateral center-edge angle <25°) were excluded. Survivorship, PROS, and clinical benefit—minimal clinically important difference (MCID) and Patient Acceptable Symptom State (PASS)—were reported. An additional propensity-matched subanalysis was performed on patients at the highest risk for conversion to arthroplasty, comparing patients undergoing capsular repair to patients with unrepaired capsules. Results: A total of 145 (n = 130 patients) out of 180 eligible hips (n = 165 patients) had a minimum 10-year follow-up (80.6%). Also, 126 hips (86.9%) belonged to women, and 19 hips (13.1%) belonged to men. The mean patient age was 30.3 ± 12.9 years. The survivorship rate was 91% at the 10-year follow-up. The cohort experienced significant improvements (P < .001) in the mHHS, NAHS, HOS-SSS, and VAS for pain scores. Moreover, the cohort achieved high rates of the PASS for the mHHS (89.8%), high rates of the MCID for the mHHS (82.4%), and high rates of the MCID for VAS for pain (80.6%) scores. In the propensity-matched subanalysis performed on patients with the highest risk for arthroplasty, 29 hips with capsular repair were matched to 81 hips with unrepaired capsules. While both groups experienced significant improvements in all PROs (P < .05), the group without capsule repair trended toward a higher conversion to arthroplasty rate when compared with the repair group. In addition, an odds ratio was calculated for the likelihood of converting to arthroplasty after having an unrepaired capsule compared with capsular repair (2.54 [95% CI, 0.873-7.37]; P = .087). Conclusion: Patients undergoing primary hip arthroscopy with capsular repair experienced a high survivorship rate of 91% at a minimum 10-year follow-up. Patients who did not convert to arthroplasty saw favorable improvements in PROs and achieved high clinical benefit rates. In addition, among those patients at the highest risk for conversion to arthroplasty, a trend toward greater survivorship was observed with capsular repair.

Capsular Repair Versus No Repair After Hip Arthroscopy in Patients Without Dysplasia or Generalized Ligamentous Laxity: A Systematic Review and Meta-analysis.

Many recent studies have shown that patients who undergo capsular repair after hip arthroscopy achieve superior clinical outcomes compared with those who do not. However, patients with dysplasia or generalized ligamentous laxity (GLL) were not excluded from most of these studies, which may have affected the outcomes. To determine whether capsular repair influences the outcomes of hip arthroscopy for patients without dysplasia or GLL. Systematic review; Level of evidence, 1. Under the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, randomized controlled trials comparing the outcomes of capsulotomy with versus without repair were included, but studies that included patients with dysplasia or GLL were excluded. The study outcomes were patient-reported outcome measures (PROMs) at 6 months and 2 years postoperatively-including the modified Harris Hip Score (mHHS), Hip Outcome Score-Activities of Daily Living (HOS-ADL), and Hip Outcome Score-Sport-Specific Subscale (HOS-SSS)- and were compared between the repair and no-repair groups. A narrative analysis and meta-analysis were performed to integrate and compare the results of the 2 groups. In the meta-analysis of the outcome measures, studies with significant differences in the preoperative scores between the repair and no-repair groups were excluded because previous studies have shown that these can affect the outcomes. A total of 761 studies were initially identified, of which 3 were included. Of the 322 included patients, 136 underwent capsular repair, and 186 underwent capsulotomy with no repair. The meta-analysis showed that capsular repair was associated with significantly higher postoperative PROMs: the mHHS at 2 years (P = .03), the HOS-ADL at 6 months (P = .02) and 2 years (P < .0001), and the HOS-SSS at 6 months (P = .02) and 2 years (P = .001). Capsular repair after hip arthroscopy was associated with superior clinical outcomes when compared with no capsular repair in patients without dysplasia or GLL.

Long-Term Outcomes of Arthroscopic Labral Treatment of Femoroacetabular Impingement in Adolescents: A Nested Propensity-Matched Analysis.

Hip arthroscopy has demonstrated effectiveness as a treatment for femoroacetabular impingement (FAI) in adult patients, with promising long-term outcomes. However, there is a paucity of literature regarding the adolescent population. The purposes of our study were to report on survivorship and patient-reported outcomes (PROs) at a minimum 10-year follow-up in adolescent patients who underwent hip arthroscopy for FAI and labral tears and to compare the survivorship and outcomes of this population with those of a nested, propensity-matched adult control group. Data regarding adolescent patients who underwent primary hip arthroscopy between February 2008 and January 2012 were reviewed. Patients with a minimum 10-year follow-up for the modified Harris hip score (mHHS), Non-Arthritic Hip Score (NAHS), Hip Outcome Score Sport-Specific Subscale (HOS-SSS), International Hip Outcome Tool-12 (iHOT-12), and visual analog scale (VAS) for pain were eligible. The exclusion criteria were previous ipsilateral hip conditions or surgical procedures, a Tönnis grade of >1, or dysplasia. In the subanalysis, adolescent patients were matched to young adult patients with use of a 1:1 ratio on the basis of sex, body mass index, Tönnis grade, lateral center-edge angle (LCEA), labral treatment, capsular treatment, and additional procedures performed during the surgery. A total of 74 patients (61 female and 13 male; 74 hips) with a mean (and standard deviation) age of 16.7 ± 1.4 years and a minimum follow-up of 10 years were included. The latest follow-up occurred at a mean of 125.4 ± 5.3 months (range, 120.0 to 144.1 months). Significant improvement in all PROs from baseline and 100% survivorship were demonstrated at the 10-year follow-up. In the subanalysis, 58 adolescent hips were propensity-matched to 58 young adult hips. The adolescent group had higher postoperative scores for the HOS-SSS (p = 0.021), NAHS (p = 0.021), and iHOT-12 (p = 0.042) than the young adult group. Patient satisfaction at the latest follow-up was also significantly higher in the adolescent group (p = 0.00061). The rate of survivorship free from conversion to THA was similar between the adolescent and control groups (100% versus 96.6%; p = 0.200). Adolescents undergoing hip arthroscopy for the treatment of FAI and labral tears demonstrated excellent outcomes and a high rate of survivorship. These outcomes were superior to those seen in a matched adult group. The results of this study indicate that hip arthroscopy in adolescents is a safe procedure that leads to improvement in outcomes at long-term follow-up. Therapeutic Level IV . See Instructions for Authors for a complete description of levels of evidence.

Patients Undergoing Postless Hip Arthroscopy Demonstrate Significantly Better Patient-Reported Outcomes and Clinically Significant Outcomes Compared to Conventional Post-Assisted Hip Arthroscopy at Short-Term Follow-Up

PurposeTo prospectively compare the short-term clinical outcomes of patients undergoing hip arthroscopy with versus without the use of a perineal post. MethodsA prospective, single-surgeon cohort study was performed on a subset of patients undergoing hip arthroscopy between 2020 and 2022. A post-free hip distraction system was used at one center at which the senior author operates, and a perineal post was used at another surgical location. An electronic survey of Patient-Reported Outcome Measures (PROMs) was completed by each patient at a minimum of 1 year postoperatively. PROMs included a Visual Analogue Scale (VAS) for pain, University of California Los Angeles (UCLA) Activity Scale, modified Harris Hip Score (mHHS), Hip Outcome Score-Sports-Specific Subscale (HOS-SSS), and a Single Assessment Numeric Evaluation (SANE). Postoperative scores and clinically significant outcomes including the minimal clinically important difference (MCID), substantial clinical benefit (SCB), and patient acceptable symptom state (PASS) for each PROM were compared between groups. ResultsSixty-nine patients were reached for follow-up (41 post, 28 postless) of 87 patients eligible for the study (79%). No significant differences were found between groups in terms of sex (post: 61% female, postless: 54% female, p = 0.54), age (post: 34 years, postless: 29 years, p = 0.11), body mass index (post: 26 kg/m2, postless: 24 kg/m2, p = 0.23) or follow-up duration (post: 24.4 months, postless: 21.3 months, p = 0.16). There was a significantly higher VAS (3.1 vs 1.4, p = 0.01), significantly lower UCLA Activity Score (7.0 vs 8.4, p = 0.02), and significantly lower mHHS (73.7 vs. 82.2, p = 0.03) in the post-assisted group. A significantly higher proportion of patients in the postless group achieved a PASS for the UCLA (89.3% vs. 68.3%, p = 0.04), mHHS (84.6% vs. 61.0%, p = 0.04), and HOS-SSS (84.0% vs. 61.0%, p = 0.048), and a SCB for HOS-SSS (72.0% vs. 41.5%, p = 0.02). One patient (2.6%) in the post group underwent revision hip arthroscopy and another was indicated for total hip arthroplasty by the time of follow-up. ConclusionPostless hip arthroscopy may result in better clinical outcomes compared to post-assisted hip arthroscopy. Level of EvidenceIII, retrospective cohort study

Six-Month Outcomes Correlate With 10-Year Outcomes After Hip Arthroscopy for Femoroacetabular Impingement Syndrome

To identify whether 6-month outcomes after hip arthroscopy for femoroacetabular impingement syndrome (FAIS) correlate with outcomes at minimum 10-year follow-up. Patients who underwent primary hip arthroscopy for FAIS from 2012 to 2013 were reviewed and included if they had 6-month and minimum 10-year follow-up. Patient-reported outcome (PRO) measures included the Hip Outcome Score Activities of Daily Living (HOS-ADL) subscale, Hip Outcome Score Sports-Specific (HOS-SS) subscale, modified Harris Hip Score (mHHS), visual analog scale (VAS) for pain, and VAS for satisfaction. We compared 6-month and 10-year outcome scores and analyzed the relations between 6-month and 1-, 2-, 5-, and 10-year outcome scores using Pearson correlation coefficients (r). Six-month scores and clinically significant outcome achievement were then compared with 10-year clinically significant outcome achievement and reoperations, including revision hip arthroscopy and conversion to total hip arthroplasty (THA), using logistic regressions and the Fisher exact test. This study included 60 patients (60.0% female sex; mean age, 36.0 ± 12.2 years). The mHHS, VAS pain score, and VAS satisfaction score significantly improved from 6-month to 10-year follow-up (P ≤ .021), whereas the HOS-ADL and HOS-SS did not (P ≥ .072). There were significant correlations between 6-month and 10-year scores for the HOS-ADL (r= 0.505), HOS-SS (r= 0.592), and mHHS (r= 0.362) (P ≤ .022 for all), as well as significant correlations between 6-month and 1-, 2-, and 5-year scores (P ≤ .014 for all). The 6-month HOS-ADL, HOS-SS, and mHHS were all significantly associated with their respective 10-year achievement of the patient acceptable symptom state (PASS) (P ≤ .044). Furthermore, 6-month HOS-ADL and mHHS were significantly associated with THA conversion (P ≤ .041). Comparable 6-month and 10-year achievement of the minimal clinically important difference (96.5% vs 97.8%, P > .999) and PASS (85.2% vs 87.5%, P > .999) for any PRO was observed. After hip arthroscopy for FAIS, patients' 6-month HOS-ADL and mHHS were significantly associated with their 10-year PROs, PASS achievement, and THA conversion, although correlation strengths decreased with increasing time from surgery. Level IV, case series.

Functional Outcome Scores and Conversion to Total Hip Arthroplasty After Hip Arthroscopy for Femoroacetabular Impingement Syndrome in Patients With Tönnis Grade 1 Versus Grade 0 Arthritis: A Propensity-Matched Study at Minimum 10-Year Follow-up

Background: Hip arthroscopy has become the mainstay surgical intervention for the treatment of femoroacetabular impingement syndrome (FAIS). However, postoperative outcomes and rates of secondary surgery are mixed in patients with differing levels of preoperative osteoarthritis (OA). Furthermore, there is a paucity of literature comparing patients with and without OA at long-term follow-up. Purpose: To compare outcomes and rates of secondary surgery at minimum 10-year follow-up, including revision hip arthroscopy and conversion to total hip arthroplasty (THA), in patients with Tönnis grade 1 undergoing hip arthroscopy for FAIS compared with a propensity-matched control group of patients with Tönnis grade 0. Study Design: Cohort study; Level of evidence, 3. Methods: Patients who underwent primary hip arthroscopy for FAIS between January 2012 and February 2013 were identified. Patients with Tönnis grade 1 were propensity matched in a 1:2 ratio by age, sex, and body mass index (BMI) to patients with Tönnis grade 0. Patient-reported outcomes (PROs) were collected at varying timepoints including preoperatively and 1, 2, 5, and 10 years postoperatively and compared between the 2 cohorts. Rates of minimal clinically important difference (MCID) and Patient Acceptable Symptom State (PASS) achievement at 10 years were evaluated and compared between groups. Rates of secondary surgery including revision hip arthroscopy and conversion to total hip arthroplasty (THA) were evaluated. Gross survivorship between cohorts was evaluated using a Kaplan-Meier gross survivorship curve. A subanalysis was performed comparing patients with Tönnis grade 1 who converted to THA and those who did not. Results: A total of 31 patients with Tönnis grade 1 (age, 42.6 ± 9.0 years; BMI, 28.0 ± 6.3) were successfully matched to 62 patients with Tönnis grade 0 (age, 42.1 ± 8.5, P = .805; BMI, 26.1 ± 3.9, P = .117). Both the Tönnis grade 1 and Tönnis grade 0 groups demonstrated significant improvements regarding all PROs at minimum 10 years (P < .05 for all), except for the Hip Outcome Score Activities of Daily Living subscale (HOS-ADL) (P = .066) in the Tönnis grade 1 cohort. No significant difference (P > .05 for all) was noted between cohorts regarding any 10-year PRO. When the authors evaluated comparisons between preoperative and 1-, 2-, 5-, and 10-year PRO measures, significant differences were noted between cohorts regarding 2-year HOS-ADL (P = .021), Hip Outcome Score Sports-Specific subscale (P = .016), and modified Harris Hip Score (P = .026); otherwise, differences did not reach significance. High rates of 10-year MCID and PASS achievement were seen, with no significant differences between groups. Patients with Tönnis grade 1 had significantly higher rates of conversion to THA compared with patients who had Tönnis grade 0 (25.8% vs 4.8%; P = .006). Patients with Tönnis grade 1 had significantly lower gross survivorship compared with those who had Tönnis grade 0 (71.0% vs 85.5%, respectively; P = .04). Conclusion: Hip arthroscopy confers comparable postoperative clinical improvements to patients who have FAIS with and without mild OA; however, the benefits among patients with mild OA may be less durable. Patients with Tönnis grade 1 had significantly higher conversion to THA and reduced gross survivorship compared with patients with no evidence of preoperative OA, suggesting that patients with evidence of OA may need to be cautioned on the higher rate of conversion surgery.

Periacetabular osteotomy with andwithout concomitant arthroscopy: a systematic review ofevidence onpost-operative activity levels andreturn to sport.

The purpose of this systematic review is to (i) compare post-operative activity levels after periacetabular osteotomy (PAO) versus PAO + HA (concomitant PAO and hip arthroscopy) using patient-reported outcomes that specifically assess activity and sports participation [Hip Disability and Osteoarthritis Outcome Score-Sport and Recreation subscale (HOOS-SR), University of California Los Angeles (UCLA) activity score, Hip Outcome Score-Sport-Specific Subscale (HOS-SSS)] and (ii) compare post-operative return to sport (RTS) data between PAO and PAO + HA groups. A systematic review of literature was conducted on 1 June 2023, utilizing PubMed, Cochrane and Embase (OVID). Articles were screened for inclusion using specific inclusion and exclusion criteria. Twenty-six out of 1610 articles metall inclusion criteria, without meeting any exclusion criteria. In the 12 studies containing only subjects who underwent PAO alone, 11 demonstrated an average score improvement in UCLA, HOOS-SR or HOS-SSS post-operatively (P < 0.05). In the three studies containing subjects who underwent PAO with concomitant HA, significant improvements were seen in the HOS-SS and UCLA scores (P < 0.05). In the five studies that directly compared UCLA, HOS-SSS and HOOS-SSS scores between PAO groups and PAO + HA groups, all demonstrated statistically significant improvement post-operatively (P < 0.05). The rate of RTS ranged from 63% to 90.8% among PAO studies and was found to be 81% in the single PAO + HA study that assessed RTS. When performed in patients with intra-articular pathology, concomitant PAO + HA may provide similar sport-related outcomes to PAO alone in patients without intra-articular pathology.

Defining Thresholds and Predictors for Achieving the Patient Acceptable Symptom State for Patient-Reported Outcome Measures After Revision Hip Arthroscopy

Background: The Patient Acceptable Symptom State (PASS) after primary hip arthroscopy has been determined; nonetheless, the PASS still needs to be defined for revision hip arthroscopy. Purpose: To define minimum 2-year follow-up PASS thresholds for the modified Harris Hip Score (mHHS), Nonarthritic Hip Score (NAHS), Hip Outcome Score–Sports Specific Subscale (HOS-SSS), visual analog scale (VAS) for pain, and International Hip Outcome Tool-12 (iHOT-12) after revision hip arthroscopy, and to identify predictors of achieving the PASS. Study Design: Case-control study; Level of evidence, 3. Methods: Data were prospectively collected and retrospectively reviewed for all patients who underwent revision hip arthroscopy between April 2017 and July 2020. Patients were included if they had baseline and minimum 2-year follow-up scores for the mHHS, NAHS, HOS-SSS, VAS for pain, and iHOT-12. PASS was calculated using the anchor-based method. Receiver operating characteristic curve analysis was used to determine the thresholds for the PASS. A multivariate logistic regression was used to identify predictors for achieving the PASS. Results: A total of 318 patients who underwent revision hip arthroscopy met the inclusion criteria. Of those patients, 292 (91.8%) had baseline and minimum 2-year follow-up. Of this group, 68 patients (72.1% female and 27.9% male; mean age, 32.9 years) answered the PASS anchor question. Achievement PASS rates were 58.8%, 41.2%, 52.9%, 60.3%, and 52.9% for the mHHS, NAHS, HOS-SSS, VAS, and iHOT-12, respectively. The area under the curve (AUC) values for the PASS for mHHS, NAHS, HOS-SSS, VAS, and iHOT-12 were 0.912, 0.888, 0.857, 0.903, and 0.871, respectively, indicating excellent discrimination. The PASS for the mHHS was 76 (sensitivity, 0.809; specificity, 0.905), for the NAHS was 86.3 (sensitivity, 0.660; specificity, 1), for the HOS-SSS was 64.3 (sensitivity, 0.745; specificity, 0.905), for the VAS was 3 (sensitivity, 0.830; specificity, 0.905), and for the iHOT-12 was 64.3 (sensitivity, 0.745; specificity, 0.905). Body mass index (BMI) was identified as a significant predictor of achieving PASS for the NAHS (OR, 0.967; 95% CI, 0.940-0.996; P = .027), as patients with a BMI ≤25.4 had 1.03 times higher odds ratio of achieving PASS for the NAHS. Conclusion: After revision hip arthroscopy, the minimum 2-year follow-up PASS thresholds for the mHHS, NAHS, HOS-SSS, VAS for pain, and iHOT-12 were 76, 86.3, 64.3, 3, and 64.3, respectively. The odds ratio of achieving PASS for the NAHS was 1.03 times higher for patients with a BMI ≤25.4.

Favorable and Durable Outcomes at 10-Year Follow-Up After Endoscopic Gluteus Medius Repair With Concomitant Hip Arthroscopy

To evaluate 10-year patient-reported outcome (PRO) scores following endoscopic surgery for gluteus medius partial and full-thickness tears with concomitant hip arthroscopy for labral tears and/or femoroacetabular impingement syndrome (FAIS). Prospectively collected data on patients followed for a minimum of 10 years after endoscopic gluteus medius repair with concomitant hip arthroscopy performed by a single surgeon were retrospectively analyzed. Patients with preoperative and 10-year follow-up for the following PROs were included: modified Harris Hip Score (mHHS), Nonarthritic Hip Score (NAHS), Hip Outcome Score-Sports Specific Subscale (HOS-SSS), and Visual Analog Scale (VAS) score for pain. There were 13 patients eligible for inclusion, 11 (84.6%) of whom had 10-year follow up, with a mean of 127.6 months (range: 120.0-140.2 months). The group consisted of 10 females (90.9%) and one male (9.1%) with a mean age at surgery of 60.1 years (range: 46.2-74.8 years). PRO scores improved from preoperative to 10-year follow-up as follows: mHHS from 60.4 to 88.0 (P= .011); NAHS from 50.1 to 90.6 (P < .001); HOS-SS from 37.5 to 85.1 (P= .001); and VAS from 4.8 to 1.2 (P= .006). Mean patient satisfaction rating was 8.3. Patients achieved PASS and MCID for mHHS and HOS-SSS at a rate of 81.8%. There was no significant decline in PROs or satisfaction between 2, 5, and 10 years postoperatively. All patients underwent concomitant hip arthroscopy and labral treatment (debridement or repair). One patient, who had arthroscopic findings of acetabular and femoral outerbridge grade 4 lesions, subsequently underwent total hip arthroplasty; however, the GM was assessed during the THA, and it was verified that the repair was intact. There were no clinical failures, secondary operations, or complications. Endoscopic repair of gluteus medius tears is a safe procedure with favorable and durable long-term outcomes at minimum 10-year follow-up. Level IV, therapeutic case series.

Endoscopic Tendon Compression Bridge Technique for Repair of Partial-Thickness Gluteus Medius Tears With Concomitant Arthroscopy for Labral Tears: Minimum 2-Year Outcomes With Benchmark Control Group

Background: The transtendinous technique has been used to treat partial-thickness gluteus medius tears in the setting of concomitant arthroscopy for labral tears. The tendon compression bridge technique for gluteus medius repair has been developed as an alternative method, providing several advantages; however, comparative studies between the 2 techniques are lacking in the literature. Purpose: (1) To evaluate the short-term patient-reported outcomes (PROs) of the tendon compression bridge technique and (2) to compare these findings with short-term PROs of the transtendinous technique. Study Design: Cohort study; Level of evidence, 3. Methods: Data were prospectively collected on patients who were followed for a minimum of 2 years after an endoscopic tendon compression bridge procedure for gluteus medius repair in the setting of concomitant hip arthroscopy for labral tears. The following PROs were collected preoperatively and postoperatively: modified Harris Hip Score, Nonarthritic Hip Score, Hip Outcome Score–Sports Specific Subscale, visual analog scale score for pain, and the International Hip Outcome Tool. Clinical outcomes were assessed using the Patient Acceptable Symptom State, minimal clinically important difference, and maximum outcome improvement satisfaction threshold. Patients were propensity matched 1:1 to a cohort that underwent gluteus medius repair using the endoscopic transtendinous technique with concomitant hip arthroscopy. Results: A total of 48 hips (48 patients) that met inclusion criteria (age, 53.3 ± 9.8 years; 92% female; body mass index, 26.7 ± 4.6), with a mean follow-up of 38.5 ± 15.7 months, were matched to 48 hips (46 patients) that underwent gluteus medius repair using the transtendinous technique. Both groups demonstrated significant improvement from preoperative scores to latest follow-up (P < .05). Mean magnitude of improvement and latest follow-up scores were not significantly different between the tendon compression bridge group and the transtendinous group, and the groups demonstrated similar favorable rates of achieving Minimal Clinically Important Difference (79% vs 79%, respectively), Patient Acceptable Symptom State (73% vs 73%, respectively), and Maximum Outcome Improvement Satisfaction threshold (65% vs 58%, respectively) for modified Harris Hip Score (P > .05). Patient satisfaction between groups was similar (8.1 ± 2.2 vs 7.7 ± 2.7, respectively) (P = .475). Conclusion: At minimum 2-year follow-up, the endoscopic tendon compression bridge technique for partial-thickness gluteus medius tears, when performed with concomitant hip arthroscopy, was associated with significant improvement in functional outcomes. These postoperative results were comparable with those of a matched cohort that underwent the endoscopic transtendinous technique for partial-thickness gluteus medius tears, suggesting that the tendon compression bridge technique for gluteus medius repair is an effective treatment option for partial-thickness gluteus medius tears.

Dancers Show Significant Improvement in Outcomes and Favorable Return-to-Dance Rates After Primary Hip Arthroscopy With Femoral Head Cartilage Status Being a Predictor of Secondary Surgical Procedures at Mid-Term Follow-Up

To report minimum 5-year follow-up patient-reported outcome measurement scores (PROMS) and return to dance in dancers who underwent primary hip arthroscopy and to identify predictors for secondary surgeries. Prospectively collected data from May 2010 and June 2016 were retrospectively reviewed. Patients were included if they participated in dance one year prior to surgery at any level, had preoperative and minimum 5-year follow-up scores for the modified Harris Hip Score (mHHS), Nonarthritic Hip Score (NAHS), Hip Outcome Score-Sports Specific Subscale (HOS-SSS), and Visual Analog Scale for pain (VAS). Exclusion criteria were previous hip conditions, previous ipsilateral hip surgery, Tönnis grade > 1, or lateral center-edge angle < 18°. The minimal clinically important difference (MCID) was reported. Dancers that discontinued dance for reasons other than pain in their operated hip were excluded from the return to dance analysis. A logistic regression model was used to identify predictors of secondary surgeries. Fifty-one hips (48 female dancers) were included. The average age and follow-up were 29.8 ± 17.2 years and 79.1 ± 23.2 months, respectively. Improvement in all PROMS (P < 0.001) was reported. Achievement rates of MCID for the mHHS, NAHS and VAS were 83.3%, 85.7% and 85.7%, respectively. Five dancers (9.8%) underwent revision hip arthroscopy and four dancers (7.8%) converted to total hip arthroplasty. The rate to return to dance was 78.6%, with 57.6% returning to the pre-injury or higher performance level. Higher femoral head Outerbridge grade was identified as a predictor for secondary surgeries [P = 0.045, odds ratio 6.752, 95% CI (1.043 - 43.688)]. Dancers following primary hip arthroscopy experienced significant improvement in all PROMS collected and achieved a high rate of the MCID at a minimum 5-year follow-up. The rate to return to dance, in dancers that did not discontinue due to lifestyle transition, was 78.6% with 57.6% returning to the pre-injury or higher performance level. Higher femoral head Outerbridge grade was found to be a predictor for secondary surgeries.

Poster 117: Dancers Following Primary Hip Arthroscopy Demonstrate Favorable Outcomes and High Rate of Return to Dance at a Minimum 5-Year Follow-Up

Objectives: The purpose is to report minimum 5-year follow-up patient-reported outcome measurement scores (PROMS) and return to dance in dancers who underwent primary hip arthroscopy, and to identify predictors for secondary surgeries Methods: Prospectively collected data from May 2010 and June 2016 was retrospectively reviewed. Patients were included if they participated in dance one year prior to surgery at any level, had preoperative and minimum 5-year follow-up scores for the modified Harris Hip Score (mHHS), Nonarthritic Hip Score (NAHS), Hip Outcome Score–Sports Specific Subscale (HOS-SSS), and Visual Analog Scale for pain (VAS). Exclusion criteria were previous hip conditions, previous ipsilateral hip surgery, Tönnis grade &gt; 1, or lateral center-edge angle &lt; 18°. The minimal clinically important difference (MCID), patient acceptable symptomatic state (PASS), and the maximum outcome improvement (MOI) were reported. A logistic regression model was used to identify predictors of secondary surgeries. Results: Fifty-one hips (48 female dancers) were included. The average age and follow-up were 29.8 ± 17.2 years and 79.1 ± 23.2 months, respectively. Improvement in all PROMS (P &lt; 0.001) was reported. Achievement rates of MCID for the mHHS, NAHS and VAS were 83.3%, 85.7% and 85.7%, respectively. Achievement rates of PASS for the mHHS and the International Hip Outcome Tool–12 were 90.5% and 81%, respectively. The MOI was 73.8% for the mHHS, and 78.6% for the NAHS. Six dancers (14.3%) underwent revision hip arthroscopy and three dancers (5.8%) converted to total hip arthroplasty. The rate to return to dance was 79.1%. Femoral head Outerbridge grade was identified as a predictor for secondary surgeries [P = 0.045, odds ratio 6.752, 95% CI [1.043 – 43.688]). Conclusions: Dancers following primary hip arthroscopy experienced significant improvement in all PROMS and achieved high rates of the MCID, PASS, and MOI at a minimum 5-year follow-up. Further, 89.3% continued to dance with 68% returning to the pre-injury or higher performance level. Femoral head Outerbridge grade was found to be a predictor for secondary surgeries.

Poster 115: Patients who Underwent Primary Hip Arthroscopy for Femoroacetabular Impingement with Acetabular Microfracture Show 77% Survivorship at 10-Year Follow-Up

Objectives: The purpose is to report minimum 10-year follow-up survivorship, defined as non- conversion to total hip arthroplasty (THA), and patient-reported outcome scores (PROS) following primary hip arthroscopy with acetabular microfracture in the setting of femoroacetabular impingement syndrome (FAIS) and acetabular chondral lesions, respectively. Methods: Data was prospectively collected and retrospectively analyzed on all patients who underwent a primary hip arthroscopy and received an acetabular microfracture between June 2009 and January 2011 and included in this study. Patients with a minimum 10-year follow-up for the modified Harris Hip Score (mHHS), Nonarthritic Hip Score (NAHS), and the visual analog scale (VAS) for pain were included. If available, the minimum 10-year follow-up for the Hip Outcome Score-Sport-Specific Subscale (HOS-SSS) was reported. The demographics, intraoperative findings, surgical procedures, PROS, rate of achieving the minimal clinical important difference (MCID), and secondary surgeries were analyzed and reported. Results: Twenty-two hips (20 patients) were included in the study, and the mean follow-up time was 124.5 ± 2.2 months. There were 17 hips (77.3%) from males and 5 hips (22.7%) from females. The average patient age at the time of surgery was 42.3 years ± 9.6. All patients on average experienced statistically significant improvement (P &lt; 0.05) between preoperative and minimum 10-year follow-up scores for all PROs. In total, 77.3% of the patients did not require conversion to THA. Additionally, 83.3% of the patients achieved the MCID for the mHHS, NAHS, and VAS for pain. Conclusions: At a minimum 10-year follow-up, survivorship of 77.3% was reported for patients that underwent primary hip arthroscopy with acetabular microfracture for the treatment of FAIS and focal/full-thickness acetabular cartilage lesions. Further, in the patients that did not require THA conversion, significant improvement in all PROS was demonstrated.

Ten-Year Survivorship, Outcomes, and Sports Participation in Athletes After Primary Hip Arthroscopy for Femoroacetabular Impingement Syndrome

Background: Hip arthroscopy is an effective treatment tool for athletes with femoroacetabular impingement (FAI) syndrome. However, long-term data are scarce. Purpose: To assess survivorship, minimum 10-year patient-reported outcome measures (PROMs), and sports participation after primary hip arthroscopy for FAI syndrome in athletes and to perform a propensity-matched comparison between patients undergoing labral debridement and labral repair. Study Design: Cohort study; Level of evidence, 3. Methods: Athletes who underwent hip arthroscopy for FAI syndrome between February 2008 and December 2010 were eligible. Exclusion criteria were other ipsilateral hip condition, Tönnis grade ≥2, or no baseline PROMs. Survivorship was defined as no conversion to total hip arthroplasty. The Patient Acceptable Symptom State (PASS), minimal clinically important difference (MCID), maximum outcome improvement (MOI) satisfaction threshold, and sports participation were reported. A propensity-matched comparison between labral debridement and labral repair was performed. Two additional propensity-matched subanalyses were performed for capsular management and cartilage damage. Results: In total, 189 hips (177 patients) were included. The mean ± SD follow-up was 127.2 ± 6.0 months. Survivorship was 85.7%. Significant improvement in all PROMs was reported (P < .001). A total of 46 athletes with labral repair were propensity matched to 46 athletes with labral debridement. This subanalysis demonstrated significant and comparable improvement in all PROMs at minimum 10-year follow-up (P < .001). For the labral repair group, the PASS achievement rates were 88.9% for the modified Harris Hip Score (mHHS) and 80% for the Hip Outcome Score–Sport Specific Subscale (HOS-SSS); the MCID achievement rates were 80.6% for the mHHS and 84% for HOS-SSS; and for the MOI satisfaction threshold, rates were 77.8%, 80.6%, and 55.6% for the mHHS, Nonarthritic Hip Score, and visual analog scale, respectively. For the labral debridement group, the PASS achievement rates were 85.3% for the mHHS and 70.4% for the HOS-SSS; the MCID achievement rates were 81.8% for the mHHS and 74.1% for HOS-SSS; and for the MOI satisfaction threshold, rates were 72.7%, 81.8%, and 66.7% for the mHHS, Nonarthritic Hip Score, and visual analog scale. Total hip arthroplasty conversions occurred significantly sooner with labral debridement than labral repair (P = .048). Age was identified as a significant predictor of achieving the PASS. Conclusion: Primary hip arthroscopy for FAI syndrome in athletes results in 85.7% survivorship and sustained PROM improvement at a minimum 10-year follow-up. A significant time delay to total hip arthroplasty conversion at 10-year follow-up was reported with labral repair over debridement, although this should be interpreted with caution, as the total number of conversions was small.